RecruitingNot ApplicableNCT07079358

Improving Veteran Referral to Cardiac Rehabilitation

Improving Veteran Referral to Cardiac Rehabilitation: A Hybrid Effectiveness-Implementation Trial

Sponsor

VA Office of Research and Development

Enrollment

816 participants

Start Date

Feb 23, 2026

Study Type

INTERVENTIONAL

Conditions

Cardiovascular Disease Cardiac Rehabilitation

Summary

This study will test whether the Veterans Cardiac Rehabilitation Referral Program (VCR2P) improves cardiac rehabilitation participation by studying 816 Veterans across three VA medical centers in Nashville, Dallas, and Gainesville over 12 months. The trial compares referral rates from the 6 months before implementing the program to 6 months after, using a "before and after" design since randomization would be impractical. The study will measure whether the program increases the proportion of eligible Veterans who receive cardiac rehabilitation referrals and whether more Veterans actually attend rehabilitation sessions. Additionally, focus groups with physicians, nurses, and Veterans will identify what helps or hinders the program's success, providing essential insights for expanding this intervention to other VA facilities nationwide if it proves effective.

Eligibility

Min Age: 18 Years

Inclusion Criteria1

All Veterans hospitalized with acute myocardial infarction, percutaneous coronary intervention, cardiac valve surgery, coronary artery bypass grafting, or systolic heart failure at the three participating VA medical centers (Nashville, Dallas, and Gainesville).

Exclusion Criteria1

however, post-hoc analysis will exclude Veterans with documented reasons preventing CR attendance including death during hospitalization or within 30 days of discharge, discharge to inpatient rehabilitation or skilled nursing facilities, significant cognitive impairment, high-risk ventricular arrhythmias, or explicit refusal of CR services.

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Interventions

BEHAVIORALVeterans Cardiac Rehabilitation Referral Program

1. A CDS tool that identifies Veterans hospitalized with CR-eligible conditions and prompts physicians to refer them to CR. 2. Educational materials that explain to Veterans the benefits and importance of participating in CR. 3. Defined responsibilities for a facility-based CR referral coordinator who will support development and oversight of the referral process.